Efficacy of Time Pressure Management in Stroke Patients With Slowed Information Processing: A Randomized Controlled Trial

Abstract 

Winkens I, Van Heugten CM, Wade DT, Habets EJ, Fasotti L. Efficacy of Time Pressure Management in stroke patients with slowed information processing: a randomized controlled trial.

Objective

To examine the effects of a Time Pressure Management (TPM) strategy taught to stroke patients with mental slowness, compared with the effects of care as usual.

Design

Randomized controlled trial with outcome assessments conducted at baseline, at the end of treatment (at 5–10wk), and at 3 months.

Setting

Eight Dutch rehabilitation centers.

Participants

Stroke patients (N=37; mean age ± SD, 51.5±9.7y) in rehabilitation programs who had a mean Barthel score ± SD at baseline of 19.6±1.1.

Intervention

Ten hours of treatment teaching patients a TPM strategy to compensate for mental slowness in real-life tasks.

Main Outcome Measures

Mental Slowness Observation Test and Mental Slowness Questionnaire.

Results

Patients were randomly assigned to the experimental treatment (n=20) and to care as usual (n=17). After 10 hours of treatment, both groups showed a significant decline in number of complaints on the Mental Slowness Questionnaire. This decline was still present at 3 months. At 3 months, the Mental Slowness Observation Test revealed significantly higher increases in speed of performance of the TPM group in comparison with the care-as-usual group (t=–2.7, P=.01).

Conclusions

Although the TPM group and the care-as-usual group both showed fewer complaints after a 3-month follow-up period, only the TPM group showed improved speed of performance on everyday tasks. Use of TPM treatment therefore is recommended when treating stroke patients with mental slowness.

Key Words: Cognitive therapy, Information processing, Rehabilitation, Stroke

List of Abbreviations: ADLs, activities of daily living, TPM, Time Pressure Management